Rights to health care should be balanced with duties to share information for reasonable purposes

It is hardly contentious to say that there is a sea change taking place in the way health information is managed in the NHS. The government’s vision—if not its practice—is clear: the power of information technology will be fully unleashed to support the provision of 21st century health care (www.connectingforhealth.nhs.uk). The flow of high quality, up to date information, accessible to patients and immediately available to appropriate health professionals, will create a virtuous circle: clinicians will be able to do a better job, and patient outcomes will improve. The world being what it is, the government’s plans have not met with unanimous applause. Setting to one side the public sector procurement nightmares, the widespread fear of the unknown, and unease about the uses to which big government will put the data, the changes have nevertheless given new energy to a long running debate: who should have control of personal information, and what should be its limits?